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PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: I(2.. l7inOA/V t Vt _ Permit No.: 2.010i� - 01375 <br /> Description of work: -R4)01 kleitt.VI ./ Date Rec'd: 10 •2 •/(,Q <br /> Septic review by: 0.1..1 &::724,44A4 Date Approved: /( / <br /> Zoning review by: e_ Date Approved: • I i <br /> Building review by: Date Approved: I!/ /�i <br /> 1 <br /> Grading review by: N A Date Approved: ------- <br /> Zoning District: Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: . Signed: Yes No Resolution/ NA <br /> Zoning: Lot Area: 4:(00 LSF AC Width: ' Structural Coverage: SF <br /> Survey Submitted: ,0 Yes 0 No Date of Survey: ID 1t E( Revised date(?): <br /> Landscape plan submitted? 0 Yes Landscaper: eP CA1T OC V 0 No/ None proposed <br /> Proposed Setbacks: No a t pun (Akin 144. DtArli. 1 <br /> Front(L e) Rear(Str ) (0 S E W ) ( N t5 1 E W ) Other Buildings etlandl <br /> Side ` ide SI✓((t <br /> --- - 157 i N, . . <br /> Building Height Analysis: <br /> Distance Between First Floor and defined T (a) <br /> Roof* (See;`building height" definition • <br /> First FloorElevation (from bui . g plans): (b) <br /> Highest Existing grou evel (per survey) or 10' (c) <br /> above lowest gr d level, whichever is lower: <br /> Difference ween (b) and (c): (d) <br /> fined Building Height (a) - (d): (e) <br /> Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> Permit Number: 0 -513 0 Yes 0 No JAN/A 0 Yes <br /> 0 Yes No / No <br /> 0 N/A-see attached r5 pepni Setback: <br /> Stormwater Quality Existing Proposed <br /> Overlay District Tier Hardcover Hardcover Variance Required CUP Required <br /> (circle one) (% and sf) (% and sf) <br /> 1 2 3 4 5 / <br /> 0 Yes ,2'No 0 Yes /(No <br /> 5-eMp Type(s): Type(s): <br /> Updated: October 2016 <br /> v:\forms\plan review checklist 10-2016.docx <br />